2014 Medicare Advantage Special

Needs Plans That Offer a $0 Premium with Full Low-Income Subsidy (LIS)

County / Company Name / Plan Name / Special Needs Plan Type / Plan’s Monthly Health Premium Beneficiary is still responsible for the plan’s monthly health & Part B premiums / Monthly Drug Premium / Annual Drug Deductible
Cook / Cigna-HealthSpring / Cigna-HealthSpringTotalCare (HMO SNP) / Dual-Eligible / $0.00 / $25.10 / $310.00
Cook / WellCare / WellCare Access (HMO SNP) / Dual-Eligible / $0.00 / $8.90 / $310.00
Cook / Community Care Alliance of Illinois, NFP / Community Care Alliance of Illinois (HMO SNP) / Dual-Eligible / $0.00 / $27.80 / $310.00
Cook / UnitedHealthcare / UnitedHealthcare Nursing Home Plan (HMO-POS SNP) / Institutional / $0.00 / $26.80 / $310.00
DuPage / Cigna-HealthSpring / Cigna-HealthSpringTotalCare (HMO SNP) / Dual-Eligible / $0.00 / $25.10 / $310.00
DuPage / Community Care Alliance of Illinois, NFP / Community Care Alliance of Illinois (HMO SNP) / Dual-Eligible / $0.00 / $27.80 / $310.00
DuPage / UnitedHealthcare / UnitedHealthcare Nursing Home Plan (HMO-POS SNP) / Institutional / $0.00 / $26.80 / $310.00
Kane / Cigna-HealthSpring / Cigna-HealthSpringTotalCare (HMO SNP) / Dual-Eligible / $0.00 / $25.10 / $310.00
Kane / WellCare / WellCare Access (HMO SNP) / Dual-Eligible / $0.00 / $8.90 / $310.00
Kane / Community Care Alliance of Illinois, NFP / Community Care Alliance of Illinois (HMO SNP) / Dual-Eligible / $0.00 / $27.80 / $310.00
Kane / UnitedHealthcare / UnitedHealthcare Nursing Home Plan (HMO-POS SNP) / Institutional / $0.00 / $26.80 / $310.00
Kankakee / WellCare / WellCare Access (HMO SNP) / Dual-Eligible / $0.00 / $8.90 / $310.00
Lake / UnitedHealthcare / UnitedHealthcare Nursing Home Plan (HMO-POS SNP) / Institutional / $0.00 / $26.80 / $310.00
McHenry / Community Care Alliance of Illinois, NFP / Community Care Alliance of Illinois (HMO SNP) / Dual-Eligible / $0.00 / $27.80 / $310.00
McHenry / Meridian Health Plan / Meridian Advantage Plan of Illinois (HMO SNP) / Dual-Eligible / $0.00 / $28.60 / $310.00
Will / Cigna-HealthSpring / Cigna-HealthSpringTotalCare (HMO SNP) / Dual-Eligible / $0.00 / $25.10 / $310.00
Will / WellCare / WellCare Access (HMO SNP) / Dual-Eligible / $0.00 / $8.90 / $310.00
Will / Community Care Alliance of Illinois, NFP / Community Care Alliance of Illinois (HMO SNP) / Dual-Eligible / $0.00 / $27.80 / $310.00

What is the Low-Income Subsidy?

The Low-Income Subsidy, also referred to as LIS or “Extra Help” is a federal prescription drug assistance program to help people with Medicare pay for their prescription drug costs. The Social Security Administration (SSA) processes LIS applications and determines eligibility and the Centers for Medicare and Medicaid Services (CMS) administers the program.

How does the Low-Income Subsidy (LIS) work with Medicare Advantage plans?

The LIS program provides the following benefits:

  • Assistance with all or a portion of the monthly drug premium and deductible
  • Lowcost prescription drug co-payments at the pharmacy
  • Part D donut hole (coverage gap) is eliminated

Beneficiary is responsible for:

  • Plan’s MonthlyHealth Premium (covers medical and hospital benefits, and may cover extra benefits not usually covered by Original Medicare such as vision or dental)
  • Part B Premium (unless enrolled in a Medicare Savings Program)
  • Medicare Advantage co-pays or co-insurance amounts for each time a health service is used (e.g., primary care doctor co-pay or inpatient hospital stay co-pay)
  • Prescription co-payments

Full LIS: between $1.20 and $6.35 for each 30-day supply filled

Partial LIS: $2.55, $6.35 or up to 15% coinsurance for each 30-day supply filled

Note: People who have both Medicare and Medicaid (called dual eligibles) and reside in a long-term care facility pay $0 co-pay for their prescription drugs. In addition, beginning in 2012, individuals who receive certain home and community based services will also pay $0 co-pays for their drugs.

How do I apply for LIS?

You may apply for LIS by submitting an application online through Social Security’s website at or by mailing in a paper application. Please contact Social Security at (800)772-1213 to request an application.

2013 Low-Income Subsidy (LIS)

Income and Asset Limits

(2014 information will be released in early 2014)

Full Low-Income Subsidy

Individual / Couple
Income / $15,516 annually
($1,293 monthly) / $20,628 annually
($1,719 monthly)
Asset / $8,580* / $13,620*

Partial Low-Income Subsidy

Individual / Couple
Income / $17,235 annually
($1,436 monthly) / $23,625 annually
($1,939 monthly)
Asset / $13,300* / $26,580*

* Resource limits include $1,500 per person burial expenses

October 2013